Reducing Risk Compared to Continued Smoking

Smoke-free alternatives for adult smokers

Smoking tobacco causes a number of serious diseases and increases the risk of early death. Tobacco control strategies in most countries focus on supply and demand measures intended to prevent initiation, reduce consumption and encourage cessation. These measures have resulted in a decline in smoking prevalence over the last three decades, but are unlikely to eliminate smoking altogether.

In fact, based on population trends, it is estimated that there will be more than 1 billion smokers by 2025, about the same number as today.

Given the number of smokers who will continue to smoke cigarettes, it makes sense to offer them less risky alternatives if technology makes it possible, and if such products can be made available. Effective policies and regulation should allow smokers to access scientifically substantiated data about these products.

Continued smoking and smoking cessation

We know from epidemiology that continued smoking results in increased risk of developing a smoking-related disease. Epidemiology has also demonstrated that if a smoker quits, the risk of developing a smoking-related disease decreases.

Conceptual depiction of the cumulated risk of smoking and the effect of cessation over time. Note that the straight lines used in this figure are for illustration purposes only as the accumulation of disease risk and the reduction upon cessation and switching to a candidate reduced-risk product follow different trajectories for specific diseases.

Since smoking cessation is the “Gold Standard” for assessing the reduction in risk for smokers, our goal is to develop products that have a risk profile as close as possible to the risk profile demonstrated by smoking cessation, while being acceptable alternatives to cigarettes.

Integrating risk reduction and acceptance for current smokers

For any smoke-free alternative to be successful in swiftly reducing harm, it has to fulfill two criteria: it must be scientifically proven to be significantly less harmful than cigarettes; and, it should be satisfying for current smokers.

The Harm Reduction equation presented at the E-Cigarette Summit by Clive Bates on 19 November 2013.

In addition to taste, and other sensory aspects, a nicotine delivery similar to cigarettes is important in achieving acceptance by adult smokers.


Experts, including the U.S. Surgeon General and the U.K. Royal College of Physicians, agree that nicotine, while addictive, is not the primary cause of smoking-related diseases. Smoking-related diseases, such as lung cancer, cardiovascular disease, and emphysema, are caused primarily by inhaling harmful compounds largely formed when tobacco is burned, not by nicotine.


As the U.S. Food and Drug Administration (FDA) has stated, “inhalation of nicotine (i.e., nicotine without the production of combustion) is of less risk to a user than the inhalation of nicotine delivered by smoke from combusted tobacco products.”